CBO Says Reform Bill Too Expensive (and 2 places to find funding)

The Congressional Budget Office has posted its analysis of the House democratic health care reform bill. The CBO says the reform bill will increase the federal budget deficit by over $1 trillion over the next 10 years. Interestingly, new revenues will decrease the deficit over the first five years, but the incremental costs of insuring more Americans and incremental payment to providers causes the deficit to balloon from 2014-2019.

The tally:

Deficit Reduction:

$196 billion – decreases in provider (not physician ) payments

$156 billion – decrease in payment to Medicare Advantage health plans

$30 billion – more rebates from pharmaceutical companies

Deficit Increase:

$245 billion – increased physician fees

The CBO document, which is brief, does not specify the other elements that will increase the budget deficit. There are substantial subsidies to allow low and moderate income Americans to purchase health insurance – and I expect that’s a large cause of the increased costs in the “out” years. Massachusetts’ legislature recently voted to deny subsidies to legal immigrants. The move is on hold due to a gubernatorial veto – but a strong indication that the cost of providing increased coverage is steep.

On another note, the New York Times had an insightful article on the front page today reminding us that not all screening tests are a good idea, and the 40 year “war on cancer” has let us down the path of increasing screening which in many instances (including prostate cancer) increases cost without a huge benefit to patients. There really are opportunities to decrease cost without sacrificing benefit.

John Iglehart had an article in the New England Journal this week about fraud and abuse. He points out that this represents at least $60 billion annually (3% of spending) – and notes that in the past Congress has been unwilling to fund efforts to root out fraud from the health care system.



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Managing Health Care Costs: Good News on Two Fronts

The Washington Post reports today that the Obama administration is pushing hard for Congress to get out of the business of setting Medicare rates. The report notes that just before leaving the Senate, Ted Stevens engineered a permanent 35% increase in Medicare rates for Alaska providers – just the kind of pork we should oppose, and an enormous market distortion. We have a serious cost per unit issue in the US – and getting the legislature’s fingers out of Medicare fee setting would be an important step.

The Massachusetts Special Commission on Health Care Payment System issued its final report today. It’s a big document (over 70 pages), and I haven’t finished digesting it yet. The report comes down firmly in favor of global payments – and pushing the development of accountable care organizations to accept capitation or other forms of bundling of payment. The Commission recommended the establishment of an independent oversight Board to oversee the transition of payment in the state – and specified that the Board should not be comprised of stakeholders.

Today saw recommendations to take Congress out of Medicare payment rates, and have an expert independent oversight Board in Massachusetts to oversee a transition away from fee for service. Perhaps this represents a blinking light at the end of the health care reform tunnel?

Tomorrow’s Washington Post reports on the Congressional Budget Office critique of the democratic health care proposals. It’s no surprise that the CBO is taking a tough line on purported savings, and this will give fiscal conservatives pause about supporting the health care reform plan in time for a bill to pass this summer. It also gives Congress a real push to identify more savings before completing the legislation. I think that these kind of savings will require the kind of payment reform that was recommended today in Massachusetts.

Good News…. And Bad News

The Council of Economic Advisors released its report on jobs of the future yesterday. The good news is that the council expects robust growth of jobs in health care.

"Health care is forecasted to remain a large source of job growth in the labor market. The long-term trend toward more employment in health care is expected to continue, with many health care occupations, including medical records and health information technicians, registered nurses, clinical laboratory technicians, and physical therapists, expected to grow." Source

Sounds good. Ironically, the highest growth is expected in ambulatory services including home health care, where MedPAC has recommended large Medicare fee cuts.

The dark side of this forecast is that if there is robust growth in health care jobs – it means that we’ll keep on spending more on health care. This is consistent with the hospital and pharmaceutical agreements to save dollars over the next decade by lowering prices while expecting higher volume of compensated services. It’s not consistent with effective health care reform and universal access with lower overall costs.